椎体成形中填充人工骨修复老年椎体压缩性骨折:3个月效果随访

Vertebroplasty with artificial bone repairs vertebral compression fractures in the elderly: 3-month follow-up results

背景:采用椎体成形治疗骨质疏松性椎体压缩性骨折时,植入的骨水泥不可吸收且强度大于正常骨组织,可引起相邻节段的再骨折。目的:探讨椎体成形中填充复合人工骨治疗老年骨质疏松性胸腰椎骨折的短期效果。方法:纳入骨质疏松性椎体压缩骨折患者21例,其中男7例,女14例,年龄61-93岁,采用椎体成形中填充注射硫酸钙人工骨治疗。治疗前、治疗后0,24,48周进行目测类比评分与Oswestry功能障碍指数评定,应用X射线及CT观察人工骨的填充及渗漏情况。结果与结论:所有患者治疗后目测类比评分与Oswestry功能障碍指数评估均较治疗前明显改善(P<0.01)。X射线及CT复查3例有渗漏,未压迫脊髓及神经,3个月后复查人工骨大部分吸收。表明椎体成形填充复合人工骨能缓解骨质疏松性椎体压缩骨折患者的疼痛症状,改善生活状态。

BACKGROUND： Bone cement used in the vertebroplasty treatment of osteoporotic vertebral compression fractures is nonabsorbable and has stronger intensity than normal bone tissue, which can cause further fractures of adjacent segments. OBJECTIVE： To investigate the short-term effect of vertebroplasty with artificial bone in the treatment of osteoporotic thoracolumbar fractures. METHODS： A total of 21 patients with osteoporotic vertebral compression fractures were enrolled, including 7 males and 14 females, aged 61-89 years old. All the patients were subjected to vertebroplasty with calcium sulfate injection. Visual analog scale and Oswestry Disability Index assessment were used before and at 0, 24, 48 weeks after treatment; meanwhile, X-rey and CT were used to observe the filling and leakage of artificial bone. RESULTS AND CONCLUSION： After treatment, all the patients showed improvements in the scores of visual analog scale and Oswestry Disability Index （P 〈 0.01）. X-reys and CT scans showed that there were three cases of leakage but without spinal cord and nerve compressions. After 3 months, most of the artificial bone was absorbed. These findings indicate that vertebroplasty with artificial bone can ease pain and improve living conditions of patients with osteoporotic vertebral compression fractures.